Organization · NPI-2
Retina Institute Of California Medical Group, A California Medical Par
Ophthalmology, Retina Specialist · Indio, CA
NPI number1063009637
StatusActive
Last updated in NPPESMay 2, 2024
Details
- NPI
- 1063009637
- Entity type
- Organization (NPI-2)
- Legal business name
- Retina Institute Of California Medical Group, A California Medical Par
- Organization subpart
- No
- Enumeration date
- Dec 29, 2020
- Certification date
- May 2, 2024
- Last updated
- May 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207WX0107X | Ophthalmology, Retina Specialist | – | – | Yes |
| 261Q00000X | Clinic/Center | – | – |
Other names
- Acuity Eye Group (Doing Business As)
Practice location
81893 Doctor Carreon Blvd Ste 2Indio, CA 92201-5592
Phone 760-342-9991 · Fax 844-897-3788
Mailing address
288 N Santa Anita Ave Ste 402Arcadia, CA 91006-3183
Phone 800-898-2020
Authorized official
Tom S Chang
Managing Partner
8008982020
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